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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration Analyst - Senior Job

Full Job Title: Senior Configuration Analyst

Job Number: 1804437

Location: Tampa, FL

Date Posted: 2018-08-21

Location: Idlewild Ave, Tampa, FL 33634
Department: Operations - Configuration
Reports to: Sr. Manager, Configuration

The Senior Configuration Analyst is responsible for accurate and timely development of automated rules and pricing. This position will also need to help develop new business plans that will help promote technology and automation.

Essential Functions:
  • Builds rules within the Peradigm System, in coordination within State and Federal guidelines
  • Monitors and tests the accuracy of price rules, fee schedules, contract loads as assigned
  • Researches both State and Federal mandates and builds interpretation grids
  • Builds and tests contracts and pricing templates for the non-par and new business teams
  • Trains/monitors staff on contract pricing and contract templates
  • Ensures proper supporting documentation and maintains files for all price rules
  • Maintains all automated reports for assigned areas.
  • Builds and maintains positive business relationships with business partners
  • Loads contracts/fee schedules into the Peradigm System through appropriate research and provider data load activities
  • Monitor and develop automated provider loads into the Peradigm
  • Monitor and develop automated batch claims processing.
  • Works with management to identify, develop, and implement tools, applications, and reports focused on increased automation, improved load quality, and input/ throughput/output measurement.
    Candidate Education:
    • Required: High School or GED
    • Preferred: Bachelor's Degree in a related field
    Candidate Experience:
    • Required: 4 years of experience in analytics or related field
    Candidate Skills:
    • Knowledge of Claims Processing
    • Understanding of contract terms and how they are loaded into the system
    • Knowledge of provider/institutional billing practices
    • Knowledge of report automation
    • Ability to effectively research issues and resolve problems
    • Process orientation; understanding of process design and flow and associated analytical tools and techniques
      Technical Skills:
      • Xcelys
      • SQL Server System
      • Statistical Analysis Systems (SAS)
      • Microsoft Excel
      • Microsoft PowerPoint
      • Knowledge of CPT/HCPCS coding
      • Knowledge of database driven programs

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        Last Updated On: 12/9/2015